Krahn L E, Rummans T A, Sharbrough F W, Jowsey S G, Cascino G D
Department of Psychiatry, Mayo Clinic, Rochester, MN 55905, USA.
Psychosomatics. 1995 Sep-Oct;36(5):487-93. doi: 10.1016/S0033-3182(95)71630-9.
Seizure surgery for medically intractable partial epilepsy in selected patients usually results in dramatically improved seizure control. However, the authors present six patients who, after surgery for refractory complex partial seizures, postoperatively experienced pseudoseizures (also known as nonepileptic seizures), confirmed with EEG monitoring. Three of these patients also had nonepileptic seizures preoperatively that coexisted with their partial epilepsy. Psychiatric assessment revealed that this patient group had several characteristics in common, which suggests that preoperative psychiatric consultation may help identify those patients at risk for developing nonepileptic seizures. Treatment strategies with anticonvulsant medications and behavioral therapy are reviewed.
对于部分选定的药物难治性局灶性癫痫患者,癫痫手术通常能显著改善癫痫控制情况。然而,作者报告了6例患者,他们在接受难治性复杂部分性癫痫手术后,经脑电图监测证实术后出现了假性癫痫发作(也称为非癫痫性发作)。其中3例患者术前也有与局灶性癫痫共存的非癫痫性发作。精神科评估显示,该患者群体有几个共同特征,这表明术前精神科会诊可能有助于识别那些有发生非癫痫性发作风险的患者。本文还综述了抗惊厥药物和行为疗法的治疗策略。